my niece is diagnosed hypothyroid and they won't increase her dose . They say it will push her into hyperthyroidism ?? Is this true

[poppppy]

hi you knowledgeable people .thank you in advance for any answers that you give your valuable time for.

my neice was diagnosed in January this year

tsh 10

free t4 11.2

now my niece has improved only slightly and the doctors will not increase her levo thyroxine even though her free t4 is just below midway in the normal range

their excuse is her tsh is too low and any more thyroxine would push it so low that she would become hyperthyroid.

my consultant never is concerned by my tsh value . Only my t3 and t4 . So I feel this is rubbish.

Latest results for my niece

Free t4 16 .1 ( 11.5 to 22. 7 )

tsh 0.68

niece is on 75 mg of thyroxine . Sorry if it is mcg I get mixed up haha

thank you

[PurpleNails Administrator]

FT3 needs to be tested too.

They are looking at the TSH which is is low but FT4 isn’t high.

[poppppy in reply to PurpleNails]

Thank you . So do u think they can increase the thyroxine dose or they should not please. Sorry to pester .Her t3 is in normal range

T3 4.6 ( 3.5 to 6.5 ) on latest results.

Thank you so much for reply

[PurpleNails Administrator in reply to poppppy]

FT4: 16.1 pmol/l (Range 11.5 - 22.7) 41.07%

FT3: 4.6 pmol/l (Range 3.5 - 6.5) 36.67%

Ok so FT4 below mid range & FT3 quite low.

As TSH low and Free in range Dr thinks adequate.

An increase will improve levels without taking over range - there plenty of room.

Increases by 25mcg and retest after 6 weeks.

This may cause TSH to go below range & that’s causes Drs to freak as they think that means they have causes too high a level. (over replaced). Over range FT4 & FT3 is not quite the same a being hyper.

If your niece stresses that her symptoms are still an issue and that FT4 & FT3 are in lower half of range there are ground for increase. Some doctors are focused on TSH so will issue a warning against allowing it to go low.

But being left unwell because the unreliable TSH doesn’t look right might be a risk she is prepared to live with.

[Regenallotment]

My GP uses a lab that won’t test T3 unless T4 is out of range so I get it done privately with a finger prick test. Your niece might want to see T3 and go from there. I think the cheapest are £29 with monitor my health. Remember the advice about testing though. Stop B complex week before, don’t eat breakfast, last Levo dose 24 hours before etc.

[poppppy in reply to Regenallotment]

I am sorry your doc lab wont test t3. I find that too . Even for my consultant at their closest lab . So i get the gp to phone the lab day after bloods taken. Then the lab do it . Only way it works. This is nhs labs. It does work . The Lab told me thats the way to get it done . Hope this tip helps u to stop paying

[DippyDame]

If one is hypothyroid it is virtually impossible to become hyperthyroid!

Her thyroid hormone levels were very low in January

Her doctor is pretty clueless and is trotting out reasons that will leave her unwell

What that medic possibly means is that on a bigger dose your niece may become overmedicated....different thing!

But with her results that is unlikely at this stage

However, her TSH of 0.68 is more likely what her doctor is concerned about....wrongly ( see link below) This is a common blunder made by medics who is leaving many patients unwell and undermedicated

originalText

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TSH is a pituitary not a thyroid hormone and reflects the level of ( total) hormones in the blood.... but gives no indication of the important levels FT4 and particularly FT3

So long as FT3 remains in range overmedication is highly unlikely

Yes it is mcg (micrograms)!

FT4 16.1 (11.5 - 22.7) is 41.07% through the ref range

We aim to have the Frees approaching 75% through ref range so at 41.07% she has plenty room to increase her dose if her symptoms still suggest undermedication.

So, no, with those labs increasing her dose will not push her into hyperthyroidism.

It would be much better to also have her FT3 result

Edit...

T3 4.6 ( 3.5 to 6.5 ) on latest results.

Her t3 is in normal range

It may be within range but that point (4.6) in the range is not optimal for your niece. What is optimal will be the actual point within the range where she feels well!!

36.67% through ref range is too low!

T3 is the active thyroid hormone and for good health must saturate almost every cell in the body

Low cellular T3 = poor health.

If your niece is still experiencing symptoms then her doctor should be adding another 25mcg levo to her 75mcg levo dose

Wait 6/8 weeks then test again....

Another visit to a GP is required.

Refer to her thyroid hormone level not her TSH.....use the link above to argue the case and for a more scientific approach use the following

originalText

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The authors are highly renowned in the thyroid field including TUK's diogenes ( Dr Midgley)

Time for a reassessment of the treatment of hypothyroidismJohn E. M. Midgley, Anthony D. Toft, Rolf Larisch, Johannes W. Dietrich & Rudolf Hoermann

Good luck!!

PS......very sorry gremlins in the system It won't allow the addition of links

Replaced by " Original Text"

Grrrrr!!!!!!